Critical care in the austere environment: Providing exceptional care in unusual places

Abstract

Adherence to sound, evidence-based, routine practice, within bounds of the circumstances, must underscore everything.

Moving Acupuncture to the Frontline of Military Medical Care: A Feasibility Study

“…There is scientific evidence to support the notion of somatotopic correspondence to different auricular (ear) regions, and therapeutic benefit derived by placing needles at these regions. [12][13][14] Because military medical staff members often operate in austere environments that do not lend themselves easily to the application of traditional acupuncture, 15,16 ear acupuncture is well-suited as an adjunctive treatment to the conventional pain management administered to a wounded patient. Ear acupuncture has demonstrated effectiveness for reducing postoperative pain 14,[17][18][19] and has been shown to reduce the amount of intraoperative pain medication administered during surgery.…”

Critical Care Aeromedical Evacuation Staff in Batang Airport After the Yushu Earthquake at High Altitude

“…In our study, there were problems such as poor coordination, lack of suitable medical equipment, no fi xed devices for stretchers and perfusion support on the airplanes, etc. Although austere settings in a disaster area could impose signifi cant challenges, the fact is that the right mix of people using the right equipment can substantially improve the outcome of patients even under those challenging circumstances ( 17 ). According to Dorlac et al, even patients with severe acute respiratory distress syndrome can be successfully transported by cooperative, properly equipped specialty teams ( 5 ).…”

Can the costs of critical care be controlled?

“…However, the absence of standardized definitions and hospital and bed comparability even within the US alone, limits efforts at local regionalization. Nevertheless, studying the CCM delivery approaches of US pseudo-regionalized systems, like the military and disaster relief units may be beneficial [46].…”